Department of Anesthesiology, Japanese Red Cross Society, Wakayama Medical Center, Wakayama City, Japan.
Int J Obstet Anesth. 2011 Jan;20(1):76-9. doi: 10.1016/j.ijoa.2010.07.014. Epub 2010 Nov 11.
The symptoms of myotonia can worsen during pregnancy and tocolysis with ritodrine has been associated with rhabdomyolysis. We describe a patient with myotonia who developed hypertonus immediately following the administration of uterotonic agents. A 24-year-old, G2P1 at 31 weeks of gestation with a history of acetazolamide-responsive myotonia presented with premature rupture of membranes. During cesarean delivery she experienced significant hypertonus of the upper limbs, shoulders, fingers, and mouth immediately after intravenous administration of oxytocin 5 IU and methylergometrine maleate 0.2mg. The mechanism underlying increased muscle tone in response to these drugs remains unclear. Anesthesiologists should be especially attentive to the administration of uterotonic drugs during the management of pregnant myotonia patients.
肌强直的症状可能会在妊娠期间加重，而利托君（ritodrine）保胎治疗与横纹肌溶解有关。我们描述了一位肌强直患者，在使用宫缩剂后立即出现了高肌张力。一位 24 岁，G2P1（孕 2 次，产 1 次），妊娠 31 周，有乙酰唑胺反应性肌强直病史，表现为胎膜早破。在行剖宫产术时，她在静脉注射催产素 5IU 和马来酸甲麦角新碱 0.2mg 后，上肢、肩部、手指和口腔立即出现明显的高肌张力。目前尚不清楚这些药物引起肌肉张力增加的机制。麻醉医生在处理妊娠肌强直患者时，应特别注意宫缩剂的使用。
